Budget Update- Training Centers, Waiting Lists and Cost-Sharing


Action Still Needed

While Virginia has been making steady progress in its transition to a community-based system since entering into the DOJ Agreement in 2012, actions taken in the Virginia General Assembly last week indicate that the Commonwealth may be close to taking a step backwards.

On Thursday, the House of Delegates passed a budget amendment that could potentially keep the Southwest Virginia Training Center (SWVTC) open, even though that institution is already scheduled to close June 30, 2018.  Later that same day, the Senate voted to pass legislation that requires (1) a plan to keep the Central Virginia Training Center (CVTC) open and (2) a plan to implement family cost sharing for Medicaid long-term care services (which includes Waivers).

Training Centers and Waiver Waiting Lists:

The House and Senate provided 144 and 150 Family and Individual Support (FIS) Waivers, respectively.  The Arc of Virginia appreciates the House and Senate making these Waivers a priority.  We do remain concerned  about the unmet needs of thousands of people who continue to wait.  Nearly 3,000 of these individuals have been identified as being in “Priority 1” status and the Commonwealth has determined that they will need services within the next year.  The DD Waiver waiting list continues to grow by hundreds of people each year.

Keeping the Training Centers open will limit the Commonwealth’s ability to respond to the DD Waiver waiting list crisis.  Maintaining the state facilities will cost the Commonwealth millions of new dollars due to unbudgeted operating and capital expenses that will be incurred.  Such actions would negatively impact the individuals who currently reside in the state institutions, as well as the 11,230 Virginians who are on the DD Waiver waiting list.

Virginia is ranked 39th in the country for its developmental disability services.  The low ranking is primarily due to the long waiting lists for services and over-reliance on expensive and outdated state institutions.   Fourteen states have already closed ALL of their state operated institutions because community-based care is cost-effective (allowing the state to serve more people) and greatly improves the quality of life of individuals who transition to community-based services. Several others states are in the transition process.   Virginia was one of the last states in the country to initiate closure of it state-operated institutions.

The statewide Training Center census  has been declining at a rapid rate due to community transitions and natural attrition.   Meanwhile, the annual cost per person for the Training Centers continues to rise and now averages $343,267 per person statewide.  Community-based services for the hundreds of people who have recently left the Training Centers (and thousands of other individuals with similar support needs) average 100-120k per person per year- which is one-third of the cost of the institutional services.   Furthermore, the demand is for community-based services, not institutional care, as evidenced by the 11,230 person waiting list for community-based services.

The Arc of Virginia believes if new dollars are going to be invested in the DD system, these dollars must be directed to respond to unmet need in the community system.  It is simply not fiscally responsible to invest in expensive and outdated institutions when we know that (1) people can be served safely and successfully in the community and (2) these dollars can be used more cost-effectively in order to respond to unmet needs in the community.

Family Cost Sharing:

The impact and parameters of the “family cost sharing” plan remain uncertain because the budget language is silent on this. The Arc of Virginia has been told that the plan would not take effect unless it was approved by the 2018 General Assembly.  We urge you to continue to express your concerns to legislators because your advocacy could affect the conversation moving forward- both now and in the 2018 session.

Advocacy Needed Now-

The House and Senate budget bills are about to go to “conference committee”, where a small group of Delegates and Senators will negotiate a final budget bill.  The “conferees” will be appointed tomorrow and are anticipated to complete their work on the budget within the next week.   Your legislator can reach out to these conferees on your behalf, asking them to ensure that the final budget bill proceeds with the Training Center closures as scheduled, supports families and commits to community-based care.

 What Can You Do?

  1. Call your state Senator and Delegate TODAY. To find out who your legislators are, click herePlease note- it is highly unlikely you will be talking with the legislator directly.  You will simply be asking to leave a message for him/her.

When you call, let your legislator know that:

  • You are very concerned about proposals that may keep the Training Centers open (326#2h, 284#6s) and the proposal to implement family cost sharing (306#14s)- these items represent a move in the wrong direction.
  • Investing in expensive outdated state institutions is not fiscally responsible. With two closures already completed, it is well documented that Virginians with complex needs can be served safely, successfully and more cost-effectively in the community.
  • Keeping the institutions open will require millions of new state dollars needed to pay for the unbudgeted operating and capital expenses, making it more difficult for the state to address the needs of the 11,000 person DD Waiver waiting list- a list that is already growing by hundreds of people per year.
  • The people who live in Training Centers do not have disabilities that are different from those who live in the community. For every person residing in the Training Center, there are hundreds, if not thousands, of people with equivalent (or greater) support needs who are on waiting lists for community-based services.
  • Urge your legislator to proceed with the closures as planned and if there is additional funding available, then it should be used to take further action on the waiting list crisis (not keep outdated institutions open).
  1. If you have time, VISIT your legislator at the Virginia General Assembly building. Contact The Arc of Virginia office (804.649.8481, ext. 104) if you would like assistance.   Remember- we only have a week to act, but constituent visits during session can make a big impact.
  1. Plan to attend your state legislators’ town hall meetings. These may be occurring soon or could take place later this spring.  Local town hall meetings are really important advocacy opportunities.   If you don’t know when your legislators’ town hall meeting is, visit his/her website, follow him/her on social media or ask when you call the legislator’s office.  Some legislators even have telephone town halls where constituents can call in with their concerns.

Help Virginia get on the right track- please take action right away.

The progress we’ve made over the last few years has not always advanced as quickly as we would have liked, but at least it was moving in the right direction.  These amendments represent a move in the wrong direction and are being proposed at a time when the future of funding for community-based services is already fairly uncertain.  Please make your calls today to help Virginia get “back on track” and strengthen its commitment to community-based care.

As always, thank you for your advocacy.


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